Pixel Tracker

Friday, February 22 , 2019, 2:29 am | Fair 42º


Susan Estrich: Who Will Run the Free Hot Dog Stand?

The private sector can't and won't replace the 'public option' of national health care

Watching conservatives cheer the demise of the “public option” has left me shaking my head.

Now, if this were a reality show — “Who Wins Health Care?” — it would all make sense. The conservatives turned the “public option” into the symbol of big, expensive government taking away your health care to give it to immigrants. I kid you not: This is exactly how I’ve heard it described in more than one television debate, which leaves you denying that you want to kill your mother (mine is already dead, but still).

Susan Estrich
Susan Estrich

It’s not easy to beat back such an idea, particularly in a country that is full of people who are on edge to begin with about their economic security, and with reason.

So score this round for the conservatives. The country doesn’t want (even) big(ger) government. The private sector does everything better. Deja vu all over again.

But is the private sector ready to run a free hot dog stand?

One of the best lines in recent political campaigns is the one where Democrats say that if the health-insurance plan members of Congress get is good enough for them, it’s good enough for everyone in America. Hooray. Sounds great.

Everyone in the country is not going to get the health-care plan Congress gets.

Most members of Congress elect one of the “best” plans available to federal employees, which is to say, they choose to get their hot dogs by appointment from whatever stand they want. Like me, they go to the $5 stand or the $10 stand, the one with the doctor you know, same-day service, and new and expensive machines. For that, you make additional contributions and pay co-pays and deductibles. Even with really good insurance, you pay.

The 40-something million Americans who don’t have health insurance are not going to be coming to my stand, whatever bill Congress passes. They can’t afford it, and we certainly can’t afford to pay for it for them. And, by the way, my insurance company isn’t exactly looking for their business, especially if they’re old (50 is old to them) or sick (gastritis counts as sick) or take prescription medicine regularly (above a certain age, who doesn’t?).

It’s not that insurance companies are a bunch of meanies who want to see people suffer. That’s a good caricature for the game of “Who Wins Health Care?” But it doesn’t happen to be true. They’re business people trying to make a living. In a field where costs are constantly spiraling and everyone wants the best, can you blame people for not wanting more lousy risks in their pool? Nothing personal.

I never bought the idea that the “public option” was going to be so good that it would keep HMOs honest. It’s a great theory. In practice, you just have to compare the waiting rooms at Kaiser to those at a public hospital such as Los Angeles County-USC Medical Center or Harbor-UCLA Medical Center to know that there is no one sitting at County with a Kaiser card in their pocket.

We have a public option now. A friend’s husband was just diagnosed with prostate cancer. They are U.S. citizens. They both work. But neither of their jobs provides health insurance. They make too much money for Medicaid and way too little to afford the $12,000 it would have cost them to insure the family with a private insurer. Now, of course, no one would take them.

He went to Harbor, the public hospital, the public option. He sat there for about 14 hours, which wasn’t so bad, and finally saw a doctor, who is ordering more tests, hopefully soon, and then they will see. At my hot dog stand, he would have had the tests already, and would have been examined by a surgeon skilled in the latest robotic techniques. He’s not asking for that. He just doesn’t want to die of something they routinely cure a few miles away.

So the conservatives win a round. Until they can answer the question of who is going to take care of my friend’s husband, who cares?

— Best-selling author Susan Estrich is the Robert Kingsley Professor of Law and Political Science at the USC Law Center and was campaign manager for 1988 Democratic presidential nominee Michael Dukakis. Click here to contact her.

Support Noozhawk Today

You are an important ally in our mission to deliver clear, objective, high-quality professional news reporting for Santa Barbara, Goleta and the rest of Santa Barbara County. Join the Hawks Club today to help keep Noozhawk soaring.

We offer four membership levels: $5 a month, $10 a month, $25 a month or $1 a week. Payments can be made using a credit card, Apple Pay or Google Pay, or click here for information on recurring credit-card payments and a mailing address for checks.

Thank you for your vital support.

Become a Noozhawk Supporter

First name
Last name
Select your monthly membership
Or choose an annual membership

Payment Information

Membership Subscription

You are enrolling in . Thank you for joining the Hawks Club.

Payment Method

Pay by Credit Card:

Mastercard, Visa, American Express, Discover
One click only, please!

Pay with Apple Pay or Google Pay:

Noozhawk partners with Stripe to provide secure invoicing and payments processing.
You may cancel your membership at any time by sending an email to .(JavaScript must be enabled to view this email address).

  • Ask
  • Vote
  • Investigate
  • Answer

Noozhawk Asks: What’s Your Question?

Welcome to Noozhawk Asks, a new feature in which you ask the questions, you help decide what Noozhawk investigates, and you work with us to find the answers.

Here’s how it works: You share your questions with us in the nearby box. In some cases, we may work with you to find the answers. In others, we may ask you to vote on your top choices to help us narrow the scope. And we’ll be regularly asking you for your feedback on a specific issue or topic.

We also expect to work together with the reader who asked the winning questions to find the answer together. Noozhawk’s objective is to come at questions from a place of curiosity and openness, and we believe a transparent collaboration is the key to achieve it.

The results of our investigation will be published here in this Noozhawk Asks section. Once or twice a month, we plan to do a review of what was asked and answered.

Thanks for asking!

Click Here to Get Started >

Reader Comments

Noozhawk is no longer accepting reader comments on our articles. Click here for the announcement. Readers are instead invited to submit letters to the editor by emailing them to [email protected]. Please provide your full name and community, as well as contact information for verification purposes only.

Daily Noozhawk

Subscribe to Noozhawk's A.M. Report, our free e-Bulletin sent out every day at 4:15 a.m. with Noozhawk's top stories, hand-picked by the editors.

Sign Up Now >